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Does transition from an unstable labour market position to permanent employment protect mental health?: results from a 14-year follow-up of school-leavers
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
2008 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 8, no 159Article in journal (Refereed) Published
Abstract [en]

Background: Having secure employment, in contrast to being unemployed, is regarded as an important determinant of health. Research and theories about the negative health consequences of unemployment indicated that transition from unemployment to a paid job could lead to improved health. The objective of this study was to test the hypothesis that obtaining permanent employment after being in an unstable labour market position protects mental health.

Methods: A 14-year follow-up of all graduates from compulsory school in an industrial town in northern Sweden was performed at ages 16, 18, 21 and 30 years. Complete data on the cohort were collected for 1044 individuals with the aid of a comprehensive questionnaire. The response rate was 96.4%. The health measurement used in this study was the psychological symptoms analysed by multivariate logistic regression. Those who obtained permanent employment were the focus of the analysis. This group consisted of people who were in an unstable labour market position for a year or more between the ages of 25 and 29, and who had acquired a permanent job one year before and at the time of the investigation.

Results: After controlling for gender as well as for an indicator of health-related selection, possible confounders and mediators, an association was found between the lower probability of psychological symptoms and obtaining permanent employment (OR = 0.35, 95% CI 0.19–0.63) as well as having permanent employment (OR = 0.22, 95% CI 0.10–0.51).

Conclusion: Our findings suggest that transition from an unstable labour market position topermanent employment could be health-promoting, even after controlling for possible confounders and mediators, as well as for an indicator of health-related selection. However, as there are few studies in the field, there is a need for more longitudinal studies in order to further analyse the relationship and to examine possible explanations. The policy implication of our study is that the transformation of unstable labour market positions into permanent employment could contribute to better public health.

Place, publisher, year, edition, pages
BioMed Central , 2008. Vol. 8, no 159
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:umu:diva-26418DOI: 10.1186/1471-2458-8-159OAI: oai:DiVA.org:umu-26418DiVA: diva2:248885
Projects
The Northern Swedish Cohort study
Available from: 2009-10-12 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
In thesis
1. From young to adult: health consequences of unemployment from a gender perspective
Open this publication in new window or tab >>From young to adult: health consequences of unemployment from a gender perspective
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background The point of departure in this thesis is that unemployment is a recognised determinant of health, which may vary between different ages and among men and women. Despite governmental policies to tackle unemployment and ease its effects on health, unemployment continues to bea growing public health problem.

Aim The objective of the thesis was to analyse, from a gender perspective, the relationships between ill health and unemployment as well as other unstable labour market positions in the transition from youth to adulthood.

The aim of each paper was: I. Does the association between ill health and unemployment differ between young people and adults? II. Is the transition from an unstable labour market position to permanent paid job health-protective? III. Is participation in labour market programmes related to mental health? IV. What is the association between ill health among men and women and how could it be analysed with a relational theory of gender?

Methods The longitudinal study was carried out in Luleå - a medium-sized industrial town in the Northern Sweden. The cohort, consisting of all 1083 pupils (506 girls and 577 boys) aged 16 who attended the last year of compulsory school in 1981, was followed up at the ages of 16, 18, 21 and 30. The response rates were high e.g. 96.4% at 14 years follow-up. The cohort was followed with extensive and well-validated questionnaires. Multivariate logistic regression was used in all papers, while propensity score matchingwas used in Paper III.

Results Paper I. Health effects of long-term unemployment differed between young people and adults. Long-term unemployment was more related to psychological ill health and smoking in young people than in adults. Paper II. The results indicated that after controlling for gender as well as for an indicator of health-related selection, possible confounders and mediators transition from an unstable labour market position to permanent employment could be health-promoting. Paper III. No association was found between participation in active labour market programmes and psychological symptoms. Due to methodological shortages the results have to be interpreted with caution. Adjustment for either all background selection variables or the propensity score in multivariate logistic regression showed similar associations suggesting that propensity score could be used to adjust for background selection variables. Paper IV. A strong association between unemployment and suboptimal self-rated health among women and high alcohol consumption among men was found and a theory of structural relations was used to discuss the gendered patterns for ill health.

Conclusion The thesis indicated gendered patterns of relations between unemployment and the health outcomes, in the transition from youth to adulthood. The policy implications of my thesis are that full employment policies should be promoted to reduce the health inequalities associated with unemployment.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2009. 68 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1299
Keyword
unemployment, reemployment, unstable labour market position, active labour market measures, psychological health, smoking, alcohol consumption, self-rated health, gender, age
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:umu:diva-26420 (URN)978-91-7264-871-5 (ISBN)
Distributor:
Allmänmedicin, 901 87, Umeå
Public defence
2009-11-02, Sal 1, byggnad 10, trappa E, Norrlands Universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Projects
The Northern Swedish Cohort study
Available from: 2009-10-12 Created: 2009-10-09 Last updated: 2009-10-12Bibliographically approved

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